Congress is poised to pass legislation would renew and expand the popular State Children's Health Insurance Program to cover four million more children over a period of more than four years. The program, which now covers 6.7 million children, is set to expire March 31. The legislation passed the House by a 289-139 vote on Jan. 14, and the Senate Finance Committee by a 12-7 vote the next day. The Senate is considering it and will likely vote soon.
Proposed spending in the U.S. Senate's stimulus package includes $3 billion more for health information technology than that proposed by the U.S. House, according to a summary released by the Senate Appropriations Committee. The summary includes $5 billion for health information technology, which comes on top of roughly $18 billion in the Senate Finance Committee's portion of the bill for health technology. The House stimulus package includes only $20 billion for health information technology.
There has been an ethical makeover under way within the medical device industry, a field that has been troubled by federal investigations and bad publicity over the volatile issue of frequently undisclosed financial ties between companies and physicians. And while there is little question that battles over how much companies, doctors and medical institutions disclose about their financial ties will continue, some experts on medical conflicts of interest see the rapid fall of resistance by most major companies indicates that a turning point has arrived.
A new study has found surprising evidence of delays in getting women with heart trouble to the hospital. Researchers at Tufts Medical Center examined 5,887 emergency calls about suspected cardiac symptoms in Dallas County, TX. About half of the calls were made by women, and about 11% were delayed, spending 45 minutes or longer in the care of emergency workers. Women were 52% more likely than men to be among the delayed, said Thomas W. Concannon, an assistant professor of medicine at Tufts University.
A growing number of workers in 2009 will pay more for health benefits, and in some cases receive less coverage, as their employers grapple with the financial fallout of rising medical expenses and diminished revenue and profits, recent surveys of human resource officials show. The Corporate Executive Board found in a survey that a quarter of officials from 350 large corporations said they had increased deductibles an average of 9% in 2008. But 30% of the employers said they expected to raise deductibles an average of 14% in 2009.
There is plenty of discussion among the consumer-driven health crowd about where one's "medical home" resides these days. Is it part of an integrated delivery system or an institutional entity, such as a mission-driven community hospital? Is it a local doc in the box or urgent care center? Some even think a health information Web site, like WebMD, or an extended social network of family, friends, and experienced patients, could function as a medical home.
So what makes us, as consumers, seek out and want to have different solutions to meet our healthcare needs and provide that medical home? It could be our level of experience, lack of standards, or belief—based on the variability in the delivery of care—that there is no system in healthcare.
Or it could be that the current leaders in healthcare are not who you think. The "real" health leaders are not C-suite executives at your local hospital or physicians and caregivers—they are empowered consumers.
Today's health leaders are the moms and dads who are struggling to navigate the healthcare system. These consumers are doing their best to lead their family through crisis, chronic condition, and routine cold and flu without the benefit of a healthcare provider taking the lead to coordinate their family's care.
But is it really about coordination of care, or is about the lack of confidence that we as consumers have in the system? As consumers, we understand convenience, service levels, quality, price, and satisfaction of experience. We call this "value for money", and it's ingrained in everyone who makes purchases.The new C-suite—healthcare consumers—is searching for value in the care that they buy.
In the book, Redefining Health Care, authors Michael E. Porter and Elizabeth Olmsted Teisberg define healthcare value as "outcomes per dollar." Even though people can debate whether an outcome is experience, satisfaction, death, or a safety event, we can all agree that the "per dollar" part is really clear.
Everyday consumers make value judgments based upon what matters most to them. They do this with calling plans, travel destinations, and service ratings that help them make decisions. These new empowered consumers are the ones creating value by defining value. Today, absent anyone noticing, consumers will draw their own conclusions and vote with their feet and wallet.
Institutional healthcare leaders should get off the "quality is king" bandwagon and realize that enormous volumes of care are given daily that have minimal impact on quality or outcomes. It's not just about quality; it's about convenience, experience, satisfaction, preference, perception, and yes, it's about the out-of-pocket price consumers pay. When healthcare leaders get on the track and begin to follow the warnings from the Centers for Medicare & Medicaid Services that value-based purchasing is just around the corner, we'll finally start to hear how they are helping consumers find value. That is a community benefit that you can sink your teeth into.
So, how can institutional healthcare leaders better serve the new C-Suite (or consumers)?
Transparency: Develop a philosophy of transparency for performance reporting.
Value: Understand your value equation (outcomes per dollar) and publish it!
Metrics: Measure differences in price, convenience, perception, satisfaction, and outcomes. Adjust your service offerings based on what works.
Communication: Formulate a communication strategy that helps consumers understand the complexity of your offerings; then, streamline the message and publish it.
Be a Consumer: Spend a day as a consumer in your own facility—take public transportation to get there; walk into the emergency room and ask for care; ask the admissions department about the cost of basic services; analyze how helpful your employees really are, and poll other patients in the waiting room about their wait time and levels of confusion.
Delivering value is about the big picture—not just quality or good food or friendly staff. And if you don't think the current economy will put new pressures on your facility's value equation, think again.
John Morrow is a health ratings innovator who has spent his career helping hospitals, consumers and payers improve their value proposition by benchmarking performance. He most recently created the Hospital Value Index® with Data Advantage and was the founder of 100 Top Hospitals: Benchmarks for Success® while at HCIA (now Thomson-Reuters).